
<div class="formulario-registro">

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<input type="hidden" id="urlok" name="urlok" value="https://eventos.lacigf.org/en/successful-registration/">
<input type="hidden" id="idiomaform" name="idiomaform" value="20">

<p class="encabezado">
Welcome to the 17th Latin American and Caribbean Internet Governance Forum - LACIGF 2024. This year the event will be held in a hybrid manner. To participate, please fill out the following form.
</p>

<div class="row">

<div class="form-group">
<label for="nombre">Name</label>
<input type="text" class="form-control" name="nombre"
id="nombre" aria-describedby="nombre" placeholder="Name" required="">
</div>

<div class="form-group">
<label for="apellido">Last name</label>
<input type="text" class="form-control" name="apellido"
id="apellido" aria-describedby="apellido" placeholder="Last name" required="">
</div>


<div class="form-group">
<label for="pais">Country</label>
<select class="form-control custom-select" name="pais" id="pais" required="">
<option value="" disabled="" selected="selected">Select an option</option>
<option value="10">Antigua y Barbuda</option>
<option value="20">Argentina</option>
<option value="30">Bahamas</option>
<option value="40">Barbados</option>
<option value="50">Belice</option>
<option value="60">Bolivia</option>
<option value="70">Brasil</option>
<option value="80">Chile</option>
<option value="90">Colombia</option>
<option value="100">Costa Rica</option>
<option value="110">Cuba</option>
<option value="120">Dominica</option>
<option value="130">Ecuador</option>
<option value="140">El Salvador</option>
<option value="150">Grenada</option>
<option value="160">Guadalupe</option>
<option value="170">Guatemala</option>
<option value="180">Guyana</option>
<option value="190">Guyana Francesa</option>
<option value="200">Haití</option>
<option value="210">Honduras</option>
<option value="220">Islas Caimán</option>
<option value="230">Islas Turcas y Caicos</option>
<option value="240">Islas Vírgenes</option>
<option value="250">Jamaica</option>
<option value="260">Martinica</option>
<option value="270">México</option>
<option value="280">Nicaragua</option>
<option value="290">Panamá</option>
<option value="300">Paraguay</option>
<option value="310">Perú</option>
<option value="320">Puerto Rico</option>
<option value="330">República Dominicana</option>
<option value="340">San Bartolomé</option>
<option value="350">San Cristóbal y Nieves</option>
<option value="360">San Vicente y las Granadinas</option>
<option value="370">Santa Lucía</option>
<option value="380">Suriname</option>
<option value="390">Trinidad y Tobago</option>
<option value="400">Uruguay</option>
<option value="410">Venezuela</option>
<option value="420">Other</option>
</select>
</div>

<div class="form-group" id="divotropais" style="display:none">
<label for="otropais">Write the country you belong to</label>
<input type="text" class="form-control" name="otropais"
id="otropais" aria-describedby="otropais" placeholder="Write the country you belong to">
</div>


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<label for="documento">Type of identification</label>
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<option value="" disabled="" selected="selected">Select an option</option>
<option value="10">Citizenship card</option>
<option value="20">Foreigner's Identity Card</option>
<option value="40">Identity Card</option>
<option value="30">Passport</option>
<option value="50">Other</option>
</select>
</div>-->

<div class="form-group" id="divotrodocumento" style="display:none">
<label for="otrodocumento">Write  the type of document</label>
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id="otrodocumento" aria-describedby="otrodocumento" placeholder="Write  the type of document">
</div>

<!--<div class="form-group">
<label for="numerodoc">Identification number</label>
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<div class="form-group">
<label for="genero">Gender</label>
<select class="form-control custom-select" name="genero" id="genero" required="">
<option value="" disabled="" selected="selected">Select an option</option>
<option value="10">Male</option>
<option value="20">Female</option>
<option value="30">No Binarie</option>
<option value="40">I prefer not to answer</option>

</select>
</div>

<div class="form-group" id="divotrogenero" style="display:none">
<label for="otrogenero">Write the gender you identify with</label>
<input type="text" class="form-control" name="otrogenero"
id="otrogenero" aria-describedby="otrogenero"placeholder="Write the gender you identify with">
</div>

<div class="form-group">
<label for="correoe">E-mail</label>
<input type="email" class="form-control" name="correoe"
id="correoe" aria-describedby=""placeholder="E-mail" required="">
</div>


<div class="form-group">
<label for="sector">Sector</label>
<select class="form-control custom-select" name="sector" id="sector" required="">
<option value="" disabled="" selected="selected">Select an option</option>
<option value="10">Academy</option>
<option value="70">Civil Society</option>
<option value="50">Government</option>
<option value="60">Media</option>
<option value="30">Private Company</option>
<option value="40">Student</option>
<option value="20">Technical community</option>
<option value="90">Parliamentary government</option>	
<option value="80">Other</option>
</select>
</div>

<div class="form-group" id="divotrosector" style="display:none">
<label for="otrosector">Write the sector to which you belong</label>
<input type="text" class="form-control" name="otrosector"
id="otrosector" aria-describedby="otrosector" placeholder="Write the sector to which you belong">
</div>

<div class="form-group">
<label for="organizacion">Organization</label>
<input type="text" class="form-control" name="organizacion"
id="organizacion" aria-describedby="organizacion" placeholder="Organization" required="">
</div>

<div class="form-group">
<label for="modalidad">Select the modality in which you will participate in the LACIGF</label>
<select class="form-control custom-select" name="modalidad" id="modalidad" required="">
<option value="" disabled="" selected="selected">Select an option</option>
<option value="10">In person</option>
<option value="20">Virtual</option>
</select>
</div>

</div>

<p class="encabezado">
LACIGF would like to know which are the most interesting topics for you or your area of work, please indicate them below:
</p>


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<div class="form-group" >
<!--<label for="areasinteres">IA y Tecnologías Emergentes</label>-->
<div>
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<label for="uno-areasinteres">AI and Emerging Technologies.</label>
</div>
<div>
<input type="checkbox" id="dos-areasinteres" name="areasinteres[]" value="20">
<label for="dos-areasinteres">Human Rights</label>
</div>
<div>
<input type="checkbox" id="tres-areasinteres" name="areasinteres[]" value="30">
<label for="tres-areasinteres">Cybersecurity</label>
</div>
<div>
<input type="checkbox" id="cuatro-areasinteres" name="areasinteres[]" value="40">
<label for="cuatro-areasinteres">Universal access and meaningful connectivity</label>
</div>
<div>
<input type="checkbox" id="cinco-areasinteres" name="areasinteres[]" value="50">
<label for="cinco-areasinteres">Digital governance and cooperation</label>
</div>
<div>
<input type="checkbox" id="seis-areasinteres" name="areasinteres[]" value="60">
<label for="seis-areasinteres">Environment and sustainability</label>
</div>
<div>
<input type="checkbox" id="siete-areasinteres" name="areasinteres[]" value="70">
<label for="siete-areasinteres">Education and digital literacy</label>
</div>
<div>
<input type="checkbox" id="ocho-areasinteres" name="areasinteres[]" value="80">
<label for="ocho-areasinteres">Gender and diversity</label>
</div>
<div>
<input type="checkbox" id="nueve-areasinteres" name="areasinteres[]" value="90">
<label for="nueve-areasinteres">Ethical and legal challenges"</label>
</div>
<div>
<input type="checkbox" id="otra-areasinteres" name="areasinteres[]" value="100">
<label for="otra-areasinteres">Other</label>
</div>
</div>

</div>

<div class="row">

<div class="form-group" id="divotrarea" style="display:none">
<label for="otrarea">Write another area of ​​work in which you are interested</label>
<input type="text" class="form-control" name="otrarea"
id="otrarea" aria-describedby="otrarea" placeholder="Write another area of ​​work in which you are interested">
</div>
	
	
	
	
	
	
<!---publicacion lista de participantes----->	
<div class="form-group">
<label for="modalidad">Do you agree with your name published on the list of participants?</label>
<select class="form-control custom-select" name="pubparticipante" id="pubparticipante" required="">
<option value="" disabled="" selected="selected">Select an option</option>
<option value="10">Yes</option>
<option value="20">No</option>
</select>
</div>
<!----------end------------>
	
	
	
	
	
	
	
	

<div class="form-group">
<label for="sitioweb">Web site</label>
<input type="url" name="sitioweb" id="sitioweb" placeholder="the URL must start with https://" pattern="https://.*" size="30">
<span id="error-message" style="color: red;"></span>
</div>

<div class="form-group">
<label for="cuentax">X Account (Optional)</label>
<input type="text" class="form-control" name="cuentax"
id="cuentax" aria-describedby="cuentax"placeholder="X Account">
</div>

</div>

<div class="check">

<div class="form-group">
<input type="checkbox" name="listalac" id="listalac">
<label for="listalac">Would you like to join the LACIGF community mailing list?</label>
</div>

<div class="form-group">
<input type="checkbox" required="" name="terminos" id="terminos">
<label for="terminos">Accept the <a target="_blank" title="Pulse para consultar más información de Aviso de Privacidad y  políticas de tratamiento de datos, abre en nueva ventana." href="https://eventos.lacigf.org/en/politica-de-privacidade-e-tratamento-de-dados/">the terms and conditions of data use.</a></label>
</div>

</div>
	
	<small>Note: If you require a letter of invitation, it is necessary to register first and then send an e-mail requesting the letter of invitation to contacto@lacigf.org.</small>

<input type="submit" value="Send">

</form>

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